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Birth trauma refers to damage of the tissues and organs of a newly delivered child, often as a result of physical pressure or trauma during
childbirth
Childbirth, also known as labour and delivery, is the ending of pregnancy where one or more babies exits the internal environment of the mother via vaginal delivery or caesarean section. In 2019, there were about 140.11 million births glob ...
. The term also encompasses the long term consequences, often of cognitive nature, of damage to the brain or cranium. Medical study of birth trauma dates to the 16th century, and the morphological consequences of mishandled delivery are described in Renaissance-era medical literature. Birth injury occupies a unique area of concern and study in the medical canon. In ICD-10 "birth trauma" occupied 49 individual codes (P10-Р15).
However, there are often clear distinctions to be made between brain damage caused by birth trauma and that induced by intrauterine asphyxia. It is also crucial to distinguish between "birth trauma" and " birth injury". Birth injuries encompass any systemic damages incurred during delivery (hypoxic
Hypoxia means a lower than normal level of oxygen, and may refer to:
Reduced or insufficient oxygen
* Hypoxia (environmental), abnormally low oxygen content of the specific environment
* Hypoxia (medical), abnormally low level of oxygen in the t ...
, toxic
Toxicity is the degree to which a chemical substance or a particular mixture of substances can damage an organism. Toxicity can refer to the effect on a whole organism, such as an animal, bacterium, or plant, as well as the effect on a subs ...
, biochemical, infection factors, etc.), but "birth trauma" focuses largely on mechanical damage. Caput succedaneum
Caput succedaneum is a neonatal condition involving a serosanguinous, subcutaneous, extraperiosteal fluid collection with poorly defined margins caused by the pressure of the presenting part of the scalp against the dilating cervix (tourniquet ef ...
, bruise
A bruise, also known as a contusion, is a type of hematoma of tissue, the most common cause being capillaries damaged by trauma, causing localized bleeding that extravasates into the surrounding interstitial tissues. Most bruises occur close ...
s, bleeding along the displacements of cranial bones, and subcapsular hematomas of the liver
The liver is a major organ only found in vertebrates which performs many essential biological functions such as detoxification of the organism, and the synthesis of proteins and biochemicals necessary for digestion and growth. In humans, it ...
are among reported birth injuries. Birth trauma, on the other hand, encompasses the enduring side effects of physical birth injuries, including the ensuing compensatory and adaptive mechanisms and the development of pathological processes (pathogenesis
Pathogenesis is the process by which a disease or disorder develops. It can include factors which contribute not only to the onset of the disease or disorder, but also to its progression and maintenance. The word comes from Greek πάθος ''pat ...
) after the damage.
Signs and symptoms
Complications from birth trauma can include damage to the head, spinal cord, soft tissues, and organs. Trauma to the head of the infant can manifest as Caput Succedaneum, skull fractures, extracranial and intracranial hemorrhages, and cranial nerve injuries. Caput Succeedaneum is seen as edema in the scalp due to squeezing of the veins from increase pressure while passing through the birth canal. Birth trauma is uncommon in the Western world in relation to rates in the third world. In the West injury occurs in 1.1% of C-sections.Causes
* Cephalo-pelvic disproportion, * the quick and rapid delivery, * delayed and prolonged delivery, * the abnormal birth position, *Asynclitic birth An asynclitic birth or asynclitism refers to the position of a fetus in the uterus such that the head of the baby is presenting first and is tilted to the shoulder, Types of Forceps Used in DeliveryFebruary 2006. Reviewer: Douglas Levine, Gynecolog ...
(asinclitismus),
* abnormal fetal attitude (extensor inserting head),
* obstetric turn,
* acceleration and stimulation of the birth,
* breech presentation,
* forceps and vacuum extraction.
While any number of injuries may occur during the birthing process, a number of specific conditions are well described. Brachial plexus palsy occurs in 0.4 to 5.1 infants per 1000 live birth. Head trauma and brain damage during delivery can lead to a number of conditions include: caput succedaneum
Caput succedaneum is a neonatal condition involving a serosanguinous, subcutaneous, extraperiosteal fluid collection with poorly defined margins caused by the pressure of the presenting part of the scalp against the dilating cervix (tourniquet ef ...
, cephalohematoma
A cephalohaematoma is a hemorrhage of blood between the skull and the periosteum of any age human, including a newborn baby secondary to rupture of blood vessels crossing the periosteum. Because the swelling is subperiosteal, its boundaries are ...
, subgaleal hemorrhage
Subgaleal hemorrhage, also known as subgaleal hematoma, is bleeding in the potential space between the skull periosteum and the scalp galea aponeurosis.
Symptoms
The diagnosis is generally clinical, with a fluctuant boggy mass developing over the ...
, subdural hemorrhage, subarachnoid hemorrhage, epidural hemorrhage, and intraventricular hemorrhage
Intraventricular hemorrhage (IVH), also known as intraventricular bleeding, is a bleeding into the brain's ventricular system, where the cerebrospinal fluid is produced and circulates through towards the subarachnoid space. It can result from phys ...
.
The most common fracture during delivery is that of the clavicle
The clavicle, or collarbone, is a slender, S-shaped long bone approximately 6 inches (15 cm) long that serves as a strut between the shoulder blade and the sternum (breastbone). There are two clavicles, one on the left and one on the r ...
(0.5%).
Epidemiology
References
External links
{{Authority control Childbirth Birth trauma